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Ten Tips For Ensuring Medication
Safety
by Seymour Ehrenpreis and Eli D.
Ehrenpreis
People over the age of 65 represent
14% of the US population but consume more than one-third
of prescription medications. The average senior citizen
uses more than five different medications each day. This
does not count nonprescription, over-the-counter drugs.
As many as 90% of seniors also use herbal remedies and
vitamins. While there is risk associated with each type
of medication - including side effects, allergic
reactions or interactions with food, alcohol or other
drugs - the risk is magnified in seniors as they are
typically more sensitive to these effects.
Well known practitioners and educators in clinical
pharmacology and internal medicines, maintain that it is
imperative that caregivers educate themselves about the
proper use of medications:
From avoiding the risk of interactions, to understanding
and following instructions for storage and dosing. The
following suggestions may help to ensure safe and
effective use of medications: Be familiar with the
dosage instructions - including whether a drug should be
taken with food, with milk or other fluids or on an
empty stomach. Not following the dosage instructions can
result in a medication being less effective or causing
complications. It is also important to note that in most
medicines recommended dosages are determined using
trials with a younger population. In many instances,
seniors may require a different dosage.
Familiarize yourself with circumstances under which the
medicine should not be taken - including a history of
allergic reactions, existing conditions, etc. This is
particularly true for the elderly who generally have a
number of medical conditions which younger adults do not
have.
Understand the storage instructions and follow them.
Because of moisture and heat, it is sometimes best not
to store medicines in the bathroom.
Be aware that there may be warnings to avoid heat, cold
or sun when taking a medication. Some medications may
cause great sensitivity to sunlight resulting in severe
sunburn or skin eruptions which can be dangerous. In
addition, it may be necessary to avoid excessive heat or
cold when taking certain prescription medications. In
such cases, saunas, whirlpools and even exercise in the
heat of the day should be greatly limited or avoided
completely. It should be noted that seniors are
particularly vulnerable to extremes of heat and cold.
Be aware of instructions about avoiding particular foods
and/or alcohol. Particular foods and beverages may be
off-limits when taking certain medications. Grapefruit
juice, a favorite among seniors, for instance, can
interact with a number of medications and render them
ineffective. It is equally important to find out if
dietary supplements may be required when taking a
particular drug. Some medications may deplete the body
of nutrients. Consequently, a patient’s diet may need to
be adjusted accordingly.
Understand what possible side effects may occur and
watch for them. Be particularly mindful of reactions or
symptoms that should be reported to a doctor
immediately. It is important to note that medicines
often affect senior citizens differently than younger
adults. What may be an innocuous reaction in a younger
person may in fact be much more serious for a senior. Be
vigilant about educating yourself on possible
drug-related reactions and be especially vigilant about
knowing which may require immediate medical attention.
Be certain to learn whether there are specific
over-the-counter medications that should be used with
caution or avoided altogether when taken along with
prescription drugs. Too often, many may assume that
over-the-counter medications are “safe” simply because
they are widely available and accessible. It is not
always recognized that some over-the-counter drugs may
actually weaken and impede a particular prescription
drug’s effectiveness. Common antacids, for example, have
the potential to minimize the effectiveness of a number
of important drugs - in particular certain antibiotics -
and the combination should be either avoided or taken
only after consultation with the treating physician or a
pharmacist.
Understand the risk associated with taking any herbal
supplements in conjunction with medications. Similar to
over-the-counter medications, many assume that herbals
are completely “safe”. Using herbs to treat specific
medical conditions has become increasingly widespread in
the not-so-distant past. Unfortunately, many physicians
and pharmacists are unaware of interactions or
complications that herbals can cause. Interactions with
herbals can reduce effectiveness of medications in a
number of cases, but in some instances herbals can
actually increase the toxicity of a medication.
Consequently, it is imperative to proceed with extreme
caution and be educated about the potential for
problems.
Familiarize yourself with what to do in the event of a
missed dose. There are instances where simply taking the
medication at the next opportunity is not recommended.
Doubling of the dose to make up for a missed dose could
be very dangerous. Such problems are compounded for
seniors who are taking several different drugs during
the day at different dosing schedules. The best way to
avoid these problems: keep a diary.
Learn how to discontinue the use of a drug. In some
instances, stopping the dosage abruptly can have severe
consequences, particularly when they are used daily over
a long period of time.
Seymour Ehrenpreis and Eli Ehrenpreis are authors of The
Prescription & Over-the-Counter Drug Guide for Seniors.
Seymour Ehrenpreis, Ph.D., is former Chairman and
currently Professor Emeritus in the Department of
Pharmacology and Molecular Biology at the Chicago
Medical School. Eli D. Ehrenpreis, M.D. is assistant
Professor of Medicine at Rush Presbyterian- St. Luke’s
Medical Center in Chicago, Illinois and a practicing
gastroenterologist in Arlington Heights, Illinois.
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